State of FL Govt Financial Report FY 2003-04Unit ID and Name:200011
Atlantic Beach
Financial Officer Name:
Fredrik N. Van Liere
Financial Officer Title:
Finance Director
Mailing Address:
800 Seminole Road
City Address:
Atlantic Beach
State:
IF1
Zip Code:
32233-5445
Email Address:
jbenjamin@coab.us
Phone Number:
(904> z47-5800
Phone Extension:
Contact Person's Name:
Jeri M. Benjamin
Contact's Phone Number:
(904) 247-5822
Contact's Extension:
5.007
FAX Number:
(904) 247-5819
Certification
We the undersigned certify, to the best of our knowledge, that the information reported
herein or submitted electronically is accurate and complete.
John S. Meserve
Name
Mayor
Title
X Signature ll C,h r1 an�f Government Board (required)
Nelson V
Name
Finance Director
Title
"5A�
X Signature of Chief Financial Officer (required)
FORM DFS -A1-401 (Rev.
Was Annual Financial Report filed electronically?
KI Yes [71 No
If yes indicate method:
K] FTP El Diskette Ed E -Mail
Date completed Audit Report was received: 05 / 23 /05
AFR Tracked
Audit Tracked
Rev/Exp
Complete
Initials Date
Amount of outstanding long-term debt: $ 21,524,542
(As of the end of fiscal year ended 09/30/2004. The term "long-term debt" means any agreement or series of agreements to pay
money, which, at inception, contemplate terms of payment exceeding 1 year in duration)
Have you experienced a financial emergency in fiscal year ended 2004? 0 Yes KI No
If yes, have you complied with Section 218.503(2), Florida Statutes? EJ Yes E] No
(ie: Have you reported a financial emergency if there has been one?)
Use separate page for response if needed.
Mail Completed Forms and Required Attachments/Enclosures to:
Department of Financial Services
State of Florida Bureau of Accounting
Annual Local Government Financial Report 200 E. Gaines Street
Fiscal Year 2003-2004 Tallahassee, Florida 32399-0354
Enter the utility service tax rates for the following:
Electricity 15.00%
Telecommunications
5.22%
Water
N/A
Natural Gas
5.007.
Cable Vision
N/A
Fuel Oil
$.02/gallon
Propane
5.007
Other
Kerosene: $.02/gallon